EESTI TEADUSTE AKADEEMIA Kohtu 6, Tallinn EE10130, ESTONIA

EESTI TEADUSTE AKADEEMIA Kohtu 6, Tallinn EE10130, ESTONIA

ESTONIAN ACADEMY OF SCIENCES phones: +372 6451 925 or +372 6448 677

fax: +372 6451 829; e-mail:

APPLICATION FOR A MOBILITY PROJECT 2018-2020

UNDER THE AGREEMENT ON SCIENTIFIC COOPERATION

BETWEEN THE ESTONIAN ACADEMY OF SCIENCES AND

THE CZECH ACADEMY OF SCIENCES

COVERSHEET

Important. This coversheet should not be detached from the application form. Applicants are required to complete this coversheet and the following parts of the form. Any additional material submitted with this application will be disregarded.

Project Title(maximum of 10 words):

ESTONIAN COOPERATING INSTITUTION AND PROJECT LEADER (name, full address):

Tel No:

E-mail:

COOPERATING INSTITUTION AND PROJECT LEADER IN CZECH REPUBLIC (name, full address):

Tel No:

E-mail:

PART I

PROJECT DETAILS

1. Give a brief account of the project proposal (maximum of 50 words):

1. Summarise the length and nature of previous contact between the two groups:

1. Outline the scientific aims of the joint project include details of how the project objectives are to be met and the timescales involved:

4. Explain the benefit to both sides from this cooperation

PART II

ESTONIAN PROJECT LEADER’S PERSONAL DATA

1. Name:

(family name)(first name) (title)

2. Date of birth: 3. Place of birth:

4. Present appointment (give the starting date, title and institution):

5. Positions held in last five years:

6. Academic qualifications (please state field and type of degree(s), year when acquired and the issuing institution):

7. Title and reference of up to six key publications relevant to this project (articles in peer-reviewed journals and/or monographs) during last five years:

PART III

CZECH PROJECT LEADER’S PERSONAL DATA

1. Name:

(family name)(first name) (title)

2. Date of birth: 3. Place of birth:

4. Present appointment (give the starting date, title and institution):

5. Positions held in last five years:

6. Academic qualifications (please state field and type of degree(s), year when acquired and the issuing institution):

7. Title and reference of up to six key publications relevant to this project (articles in peer-reviewed journals and/or monographs) during last five years:

PART IV

OTHER PROJECT PARTICIPANTS

Give names, titles, job status, institution of other project participants (both in Estonia and in Czech Republic):

PART V

OUTPUTS

Please state the policy agreed between the two groups concerning publication of results and Intellectual Property Rights (IPR).

PART VI

EXPECTED VISITS UNDER THE PROJECT

Please give details of the visits scheduled from both sides according to the guidelines:

PART VII

SIGNATURES (please add date of signing)

Applicants are asked to submit the completed form electronically by 31 May 2017 to:

Please address any inquiries you might have to Mgr. Ülle Raud tel. +372 645 1925, mobile phone: +372 50 42 659, e-mail: .

NB! Your Czech partner has to submit the application to the Czech Academy of Sciences by the deadline set by the Czech Academy of Sciences and using the application form required by the Czech Academy of Sciences.

For an application form required and further information, the Czech partner is welcome to contact Mgr. Dana Pazourková tel. +420-221 403 467, e-mail: .